08/14/2025
The National Certification Corporation (NCC) Obstetric Emergencies (C-OBE) Subspecialty Certification is earned when candidates prove their ability to assess, identify, manage, and treat obstetric and postpartum emergencies. I took this test in early July and just found out today I passed!
Christina Buchanan, MSN, CNM, RNC-OBE
That means I spent many, many hours brushing up on all aspects of the following...knowledge I don't need often, but its better to have it and not need it than need it and not have it!
IDENTIFICATION, MANAGEMENT, AND TREATMENT OF OBSTETRIC
AND POSTPARTUM EMERGENCIES
I. Medical Emergencies
• Endocrine
- Ketoacidosis (DKA) and Coma
- Hypoglycemia
- Insulin
• Respiratory
- Asthma
- Pulmonary Edema
- Acute Respiratory Distress Syndrome (ARDS)
• Cardiovascular
- Myocardial Infarction
- Stroke
- Arrythmia
- Aortic Dissection
- Peripartum Cardiomyopathy
• Renal / Hepatic / Splenic
- Acute Fatty Liver of Pregnancy
- Acute Kidney Failure
- Liver Hematoma/Rupture
• Neurologic
- Seizure
• Hematological
- Venous Thromboembolism (VTE) / Pulmonary
Embolism
- Anticoagulants / Thrombolytics
- Sickle Cell Crisis
• Overdose
• Trauma
- Motor Vehicle Accidents
- Assault
- Domestic Abuse
- Falls
II. Intrapartum and Postpartum Emergencies
• Umbilical Cord Prolapse
• Anesthesia Complications
- Malignant Hyperthermia
- High Spinal
- Anaphylaxis
• Shoulder Dystocia
• Breech Vaginal Delivery
III. Infection and Sepsis
• Pyelonephritis
• Intraamniotic Infection
• Endometritis
• Respiratory Infections
- Viral
- Bacterial
• Antibiotics
IV. Maternal Resuscitation
• Amniotic Fluid Embolism / Anaphylactoid Syndrome
of Pregnancy
• Maternal Arrest
• Shock
- Septic
- Cardiogenic
- Hemorrhagic
- Vasopressors
V. Hypertension
• Preeclampsia / Eclampsia / HELLP
• Hypertensive Crisis
• Antihypertensives
• Seizure Prophylaxis
VI. Hemorrhage
• Ectopic Pregnancy
• Placental Abruption
• Placenta Accreta Spectrum
- Accreta
- Increta
- Percreta
• Postpartum Hemorrhage
- Uterine Mechanical Devices (Jada/Bakri/Packing Safety and Use)
- Mass Transfusion (Use of Blood
Products/Transfusion Protocols)
- Disseminated Intravascular Coagulation (DIC)
- QBL Quantification
- Uterotonics
- Tranexamic Acid (TXA)
• Uterine Rupture
• Placenta Previa
• Uterine Inversion
PROFESSIONAL PRACTICE
Social Determinants of Health, Bias, Maternal
I. Morbidity and Mortality
• Equitable Care
• Implicit Bias
• Trauma Informed Care
II. Interdisciplinary Teamwork, Ethical Issues, and
Quality Improvement
• Surgical Preparation and Care Coordination
• Communication with Families
• Closed Loop Communication
• Continuous Feedback Loops
• Debriefing
ASSESSMENT AND PREVENTION
I. Pre-Existing Conditions
• History of Pre-Existing Conditions (Medical History,
Surgical History, Past Obstetrical History)
• Pregnancy Conditions (Current Pregnancy)
• Assessment of Mental Health/Substance Use
Disorder Issues, Ethical and Legal Considerations
II. Risk Assessment and Clinical Risk Factors
• Ongoing Assessment of Maternal Risk Throughout
the Hospital Stay
• Health Disparities
III. Physical Exam and Diagnostic Studies
• Early and Late Signs and Symptoms of Maternal
Decompensation in Obstetrical Emergencies
• Vital Signs and Hemodynamic Changes
